HomeMy WebLinkAboutF2021-0274 - Permit Application�iWFOgl
Worksheet for Fire Permit Application
Please print 3 copies -owr"
Print Form �
City of Newport Beach - Building Division
Associated Building Permit #
X2020-1556 r. Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Floor
Suite No
304 Jasmine Ave
Tenant Name F
# Units
F
2. Description of Work
Fire sprinklers for new SFR (41 sprinklers)
F
Use
----
---
_ _
Valuation $ 6,000
Extg Sq Ft New/Added Sq Ft ;Total Sq Ft
�,
# Stories �3
)— New F_Add F—Alter (` Demo
Check Appropriate Box for Applicant/Notification
.4
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3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
9
City r State I---- Zip
F--_ TelephoneF�
3 FX( R. Architect/Designer's Name Last Vo
Firstrjohn Lic.
No.� '
Architect/Designer's Address
Architect/Designer's E-mail Address
526 N Shadydale Ave
fireguardss@gmail.com
city West Covina State CA Zip 91790 _ Telephone 714-310-0194
t
5. Engineer's Name Last
First Lic. No.F---'
Engineer's Address
Engineer's E-mail Address
City � _ __. i State Zip
F_ Telephoned
FR 6 Contractor's Name Last Fireguard Sprinkler Systems,
First F_ --� — Lic No. 992002
Class 16
Contractor's Address
Contractor's E-mail Address
7907 Leeds Street
fireguardss@gmail.com
i City Downev State CA Zip
90242 Telephone�714-310-0194
I OFFPCE USE ONLY jl� ^ 1� /��i-{/�2j PERMIT NO.
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7
TYPE OF CONSTRUCTION �/ GGJI
PLAN CHECK NO.
OCCUPANCY - GROUP �/2/^J��
�! n PLAN CHECK FEE $